Value Health Partners
Update
 
July, 2010
In This Issue
Advocacy
PAC
Diabetes
Stroke
Value Maximization
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Advocacy
 

In this year's state budget, dollars were returned for the support the 'outstate' DSH (Disproportionate Share) pool.  As you recall, those dollars were put in the budget last year,  only to have Governor Granholm line item veto the amount  ($5 million) for the outstate hospitals and keep the $45 million for Detroit.  This year again, we are requesting reinstatement of the $5M DSH.

VHP is also recommending to the state a more equitable method to distribute all of the DSH pools.  Currently, the lopsided methodology benefits primarily one health system. Detroit Medical Center receives $33M of the $45M pool and has for the past 30 years. 

PAC
 

Fund raising is underway for the Value Health Partners Political Action Committee (VHP-PAC) fund.  VHP developed a PAC to consistently keep legislators engaged and informed about issues that matter most to us:  our patients.  We focus on the need for fairness in the disproportionate fund, the value of using the Certificate of Need process and Medicaid shortfalls.

 
Diabetes
 

The Diabetes Educators have identified a trend within our members.  The incidence of people being diagnosed with diabetes is dramatically increasing while attendance at the Diabetes Education classes is either level or decreasing.  

In 1980, six (6) million people suffered with diabetes.  In 2008, 24 million people have the disease.  In Michigan alone, the cost for direct and indirect medical costs is $6.5 Billion.  Diabetes Self Management Education has demonstrated a 4:1 return on investment.

An opportunity exists to reach more people.  A Master's level nursing student began a study to compare four (4) models of delivery for diabetes self management. They were:

1.      Traditional hospital-based diabetes education.

2.      Traditional hospital-based diabetes education in a facility that also has a diabetic clinic.

3.      A primary care physicians group.

4.      A for-profit educational service.

 
The results are being finalized. 
Stroke
 

Stroke impacts over 8,000 people per year JUST in the VHP member area.  In the first year, 25% (2,000 people) will die, 31% (2,480) will require assistance with daily living activities and another 15% (1,280) will require institutionalization after hospitalization.

The VHP Community workgroup obtained agreement from the VHP Quality workgroup to develop a stroke dashboard.  The key piece of information is the amount of patients who receive thrombolytic therapy.  Quinn and Dawson (2009) determined that a 4% increase in the utilization of thrombolytics would create a healthcare savings of $15 Million.

The VHP Community workgroup met with the Stroke Clinical Leaders from member organizations.  We are in the process of developing a 5-year work plan and obtaining external funding.

Value Maximization
 
 
 
Congratulations to:
  • Spectrum Health for receiving recognition as one of the Top 10 Quality Systems in the Country!
     
  • Bronson Methodist Hospital and Munson Medical Center for being ranked as the nation's top 5% for emergency medical care according to a new HealthGrades study!
 
Annual Quality and Safety Symposium
Adaptive Design
·          Historic organizational structures, methods and mindsets are not adaptive.
·          Adaptive = Future
·          Develop responsive, coordinated rapid decision making close to the information.
·          Act your way to a new way of thinking.
·          Innovation = New Value
Designed to Adapt: Leading Healthcare in Changing Times - John Kennagy 2009
These are the major messages from John Kennagy's presentation "Designed to Adapt:  Innovation, the Human Brain and Healthcare" at the Spectrum Health System Quality and Safety Symposium held on May 26 at DeVos Hall.  The conference hosted national speakers:
·         Craig Clapper, PE, CMQ/OE Healthcare Performance Improvement "Putting Safety Culture to Work"
·         Stephen Mathing, MD "The Journey to Become a High reliability Organization: The Cincinnati Children's
                                    Experience"
·         Mary Anne Hilliard Esq., BSN, CPHRM "Litigation and Patient Safety at Children's National Medical Center"
VHP members were invited to this symposium and presentation slides are downloaded and available on the VHP website in the Value Maximization Document Library.
Healthcare Performance Improvement Course
Covenant Healthcare members completed the 10-day Healthcare Performance Improvement Course with a six-member team focusing on the improvement of STEMI processes for patients who receive lifesaving treatment for heart attacks.  Clinical evidence demonstrates that shortening the time span from the arrival to the ED to treatment in the Cardiac Cath Lab saves lives.
CMS core measure reimbursement increases with the improvement of the National Quality Measure:
·          AMI-8a:  Improvement of the percentage of patients that receive PCI in 90 minutes or less
The team goal was to hardwire processes in the ED and develop teamwork with the Cardiac Cath Lab staff to achieve a goal of 60 minutes of less.  Team members process mapped the patient processes in the ED and the Cath Lab.  Team presentations to leadership were held on June 18.  A copy of their presentation is posted in the Value Maximization Document Library.  Team members included:
·          Dan Kaleyta, Six Sigma Black Belt - Team Leader
·          Deb Best, RN, MSN Cardiovascular CNS
·          Kathy Meyer, RN, MSN Cardiac Network Administrator
·          Deanna Knopp RN, Co-Manager Emergency Care Center and Clinical Decision Unit
·          Barbara Laking, BSN, RN , Emergency RN
·          Yvette Scharf, BSN, RN, Emergency RN
New Dashboards
The Value Maximization Team and Partnership health system Decision Support groups have added 5 new dashboards:
·          Abdominal Aortic Aneurysm - Rupture
·          Ischemic Stroke
·          Laminectomy
·          Lumbar Fusion
·          Surgical Care Improvement Project
There are now 14 disease state dashboards in the Partnership.